Surgeon Found Guilty of Misconduct After Teen's Death

A surgeon who operated on an 18-year-old woman who died three days later following a significant bleed has been found guilty of professional misconduct and poor professional performance by a fitness-to-practise committee. Dr Ashish Uday Lal performed the surgery on Jessica Sheedy, from Caherguillamore, Bruff, Co Limerick, to remove a benign tumour from her abdomen on May 8th, 2018 while practicing as a consultant surgeon at University Hospital Limerick (UHL), However, during the procedure Ms Sheedy sustained a significant bleed and died three days later on May 11th. At the Medical Council fitness-to-practice inquiry on Tuesday, Dr Lal was the subject of a number of factual allegations in relation to the care he provided to Ms Sheedy, between November 23rd, 2017 and May 11th, 2018, to which he made full admissions. The committee found each of the allegations had been proven beyond reasonable doubt and each amounted to a “serious failing”. These allegations included that Dr Lal failed to consider a non-operative strategy for Ms Sheedy and/or discuss this option adequately or at all with Ms Sheedy and/or her family. It was also alleged Dr Lal presented the case for carrying out the surgery before an oncology multidisciplinary team meeting on January 19th, 2018, in circumstances where he knew, or ought to have known, that this was not the appropriate forum to discuss the treatment plan and/or consideration of surgery in relation to Ms Sheedy. It was further alleged that Dr Lal made the decision to proceed with surgery without any and/or any sufficient consultation with his surgical and/or vascular colleagues. It was also alleged he failed to consult and/or place the vascular team on notice of the details of the surgery so as to facilitate assistance. The inquiry heard that Prof Eamon Kavanagh, consultant vascular surgeon, said Ms Sheedy’s case was complex but that Dr Lal had not mentioned it when he had seen him briefly in the tea-room before the operation, which surprised him. [ Limerick hospital apologises over death of teenager after surgeryOpens in new window ] It was also alleged Dr Lal carried out the surgery in circumstances where CT images were available for a number of weeks before the surgery but that he failed to review them with a consultant radiologist in advance of the operation. It was also alleged he made the decision to proceed to surgery in circumstances where he did not have the appropriate experience. It was further alleged Dr Lal made an inadequate incision and exposure to an area in the back of the abdomen through a left diagonal incision of Ms Sheedy’s upper abdomen, when he knew or ought to have known this was not the appropriate decision. The inquiry heard Dr Lal had advised Ms Sheedy that after the operation there would be a scar from her groin to her ribs. It was also alleged that when uncontrolled bleeding began during the surgery Dr Lal failed to take appropriate steps by stopping or pausing the procedure and failing to await vascular surgical assistance. The inquiry heard Dr Lal admitted that he did not seek vascular surgery assistance in a timely manner. Anaesthetic nurse, Elaine Lyons phoned Prof Kavanagh from her mobile phone but Dr Lal declined to talk to Prof Kavanagh and did not give a reason for this, the inquiry heard. Ms Lyons made a second call requesting that Prof Kavanagh come immediately. Prof Kavanagh told Ms Lyons to tell Dr Lal that he was on the phone if he needed help, but Dr Lal said that he did not need assistance, the inquiry heard. It heard the reason for the bleeding during the surgery was probably a torn hole in the aorta but that there were also additional bleeding points. The committee found professional misconduct had been proven in relation to the allegations regarding the January 2018 multidisciplinary meeting and Dr Lal’s failure to stop or pause the surgery on commencement of the uncontrolled bleeding. A finding of professional misconduct was also found in relation to an allegation that Dr Lal had provided a misleading statement that he had obtained a second opinion from Mr Dirk Strauss at Royal Marsden Hospital, Chelsea, on proceeding with a biopsy. The committee also found that the conduct of Dr Lal in 10 of the allegations amounted to poor professional performance. The committee will reconvene on Wednesday to hear submissions as to sanction.